Leishmaniasis is caused in humans and animals by protozoan parasites from several leishmania species that are transmitted to hosts by the bites of infected female phlebotomine sandflies.
There are three main human forms of leishmaniasis—visceral (often known as kala-azar and the most serious form of the disease), cutaneous (the most common), and mucocutaneous (the most disfiguring). Most leishmaniases are zoonoses (diseases that can be transmitted from animals to humans) and the reservoir hosts include many species of mammals. Dogs are important reservoirs of L. infantum responsible for visceral leishmaniasis.
Animals can also suffer from visceral, cutaneous and mucocutaneous forms of the disease.
It is estimated that 350 million people are at risk of the disease (most of them are children), with 1.3 million new cases and 20 000 to 30 000 deaths per year. (Leishmaniasis Worldwide and Global Estimates of Its Incidence. Alvar J. et al. (2012) PLoS ONE 7(5): e35671. doi:10.1371/journal.pone.0035671).
Current treatments have serious drawbacks in terms of efficacy, safety, drug resistance, stability, cost and the majority lack an oral dosing option (Structures, Targets and Recent Approaches in Anti-Leishmanial Drug Discovery and Development. Seifert K., Open Med Chem J. 2011; 5:31-39. doi: 10.2174/1874104501105010031). Geographical efficacy variation in the current treatments has started to be observed—for example, the efficacy of liposomal amphotericin B in East Africa is below what is seen in the Indian sub-continent for the same dosage ((a) Berman J D, Badaro R, Thakur C P, Wasunna K M, Behbehani K, et al. (1998) Efficacy and safety of liposomal amphotericin B (AmBisome) for visceral leishmaniasis in endemic developing countries. Bull World Health Organ 76: 25-32. (b) Eltahir A. G. Khalil, Teklu Weldegebreal, Brima M. Younis et al. Safety and Efficacy of Single Dose versus Multiple Doses of AmBisome® for Treatment of Visceral Leishmaniasis in Eastern Africa: A Randomised Trial. PLOS Neglected Tropical Diseases: published 16 Jan. 2014 (info:doi/10.1371/journal.pntd.0002613). Efficacy rates are also found to vary within Africa (Hailu A, Musa A, Wasunna M, Balasegaram M, Yifru S, et al. (2010) Geographical Variation in the Response of Visceral Leishmaniasis to Paromomycin in East Africa: A Multicentre, Open-Label, Randomized Trial. PLoS Negl Trop Dis 4(10): e709. doi: 10.1371/journal.pntd.0000709).
As such there is a real unmet medical need for new oral drugs and combination therapy for the treatment and potential elimination of this disease in certain geographical areas, requiring the development of multiple new oral agents.
WO 2005/121107 and US 2005/277655 disclose certain pyrazolo-pyrimidine compounds as cyclin-dependent kinase inhibitors useful for the treatment of cancer.
WO 2008/09457, WO 2008/094602 and Bioorganic & Medicinal Chemistry Letters (2011), 21(18), 5633-5637 disclose certain pyrazolo-pyrimidine compounds as protein kinase inhibitors useful for the treatment of cancer.